Screening New Patients for Potentially Problematic Behavior
Managing patients who have difficult behaviors or who are nonadherent with their care plans is a persistent issue that healthcare providers face. If a patient who has these issues is already under your care, various risk management strategies can help you manage the situation. However, difficult patient behavior and nonadherence still can be frustrating, stressful, and time-consuming.
Initial consultations with new patients offer practitioners a unique opportunity to identify potential signs of difficult or nonadherent behavior. By proactively screening for such issues, you might determine that some patients are not a good fit for your practice before establishing a duty to care. Below are some considerations for screening new patients for potentially difficult or nonadherent behavior:
- Obtain patients’ health records in advance, if possible, and carefully review each patient’s medical history.
- Determine whether gaps exist in patients’ health information or medical histories that might indicate nonadherence to recommended care and treatment.
- Consider whether patients’ health records indicate a history of multiple complaints of vague symptoms without clear etiology.
- Discuss patients’ expectations, and assess whether they are realistic based on the standard of care, patients’ conditions, and other relevant factors.
- Ask patients why they are choosing your practice and about their long-term healthcare goals. Be mindful of whether patients seems evasive in answering these questions or questions about previous care.
- Pay attention to whether patients mention dissatisfaction with previous healthcare providers, and whether they have a history of doctor shopping.
- Determine whether patients have to travel a long distance to get to your office and whether they have transportation issues.
If you decide that some patients are not a good fit for your practice, do not charge them for their initial visits. Tell patients that you cannot meet their needs, and advise them to find another healthcare provider.
When you do decide to accept new patients into the practice, clarifying boundaries, limitations, and expectations is essential. A thorough informed consent process can help establish expectations related to treatment and procedures. Documentation of the informed consent process and all patient education will help reinforce your efforts to clearly and thoroughly communicate with patients.
